The following forms can be downloaded and printed. Please fill out the forms and bring in all required documents to the clinic to establish a new chart. If you have any questions, please call 505-908-2307.
Do Not Email forms back to clinic, they will not be accepted.
New Patient Forms
CBNHC New Patient Registration Packet 2021
Health Board Forms
Canoncito Band of Navajos Health Center, Inc. is currently accepting Letters of Interest with a Resume/Application for one (1) position on its Five (5) member Board of Directors. The position will fill a 3-year term beginning July 2021 to March 2024.
Applications accepted from May 24, 2021 to June 11, 2021 @ 3:00pm MSDST